Determining whether the anxiety disorder or the addiction came first is often challenging, creating a ‘chicken or the egg’ paradox. However, examining each scenario sheds light on both conditions.
Anxiety disorder leading to addiction
Individuals with anxiety may be more susceptible to addiction due to reasons such as;
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Self-medication: Some individuals may use substances (such as drugs or alcohol) or participate in addictive behaviours (like gambling) to alleviate their anxiety symptoms. Although these avenues may provide temporary relief, participating in them frequently leads to a higher risk of developing an addiction.
Neurobiological factors: There may be shared neurobiological vulnerabilities between anxiety and addiction. Both conditions can involve dysregulation of brain chemicals like serotonin, dopamine and norepinephrine, which play a role in mood regulation and reward pathways. For example, suppose an individual with an anxiety disorder has an imbalance in serotonin. In that case, this can increase their vulnerability to seek substances or engage in addictive behaviours to restore a sense of balance or pleasure in the brain.
Environmental factors: Environmental factors, such as stressful life events or a history of trauma, can contribute to anxiety disorders and addiction. These factors can increase the likelihood of using substances or engaging in addictive behaviours to cope with stress or trauma.
Addiction leading to anxiety disorder
On the other hand, individuals with addictions may be more susceptible to developing anxiety disorders due to:
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Withdrawal and Post-Acute Withdrawal Syndrome (PAWS): During withdrawal from addictive substances, individuals may experience intense anxiety symptoms as part of the withdrawal process. These symptoms can persist even after the acute withdrawal phase, known as Post-Acute Withdrawal Syndrome (PAWS), potentially leading to anxiety disorders.
Psychological and environmental factors: Addiction can lead to various psychological and environmental stressors, such as financial difficulties, relationship hurdles, legal issues and social isolation. These stressors can contribute to the development or exacerbation of anxiety disorders.
Fear and worry: Addiction can cause individuals to worry about their ability to obtain or use the substance, leading to increased fear and anxiety. This can result in a vicious cycle of substance abuse and anxiety, with the addiction fueling the worry and the worry fueling the addiction. Breaking this cycle often requires professional help and support.
Whether anxiety precedes addiction or vice versa, the important aspect is recognising and addressing both one after the other in treatment. Researchers have suggested considering the readiness of each individual to make changes in their presenting disorders. For example, If you show a greater readiness to address your addiction than your anxiety disorder/s, starting addiction treatment first is recommended. Once you are stable with your primary condition, the secondary condition can be treated.
So how can Recovery Lighthouse help with treatment?
